25 January 2008

Too 'fat' to give birth in hospital

Melbourne mother, Lisa Graves, has been told she is too 'fat' to give birth at her local hospital. At 100kg, Lisa will have to pay for private medical care and travel far from her home to receive the prenatal care she needs.
Why the shaming of 'fat' mothers is wrong

I've talked to dozens of women in Melbourne, all of whom are pregnant, and all of whom told me they feared if they gained ‘too much’ weight or failed to ‘bounce back’, they would no longer be valued as human beings.

The story of Berwick mother, Lisa Graves, proves that their fears are justified. How is it that the paradigm of obstetrics has changed into one in which Australian pregnant women must be legitimately afraid that they will be rejected for prenatal care if their body weight deviates from medical guidelines?

The shaming of fat people, fat women in particular, is a cottage industry in a culture that thrives on size zero and reality shows like The Biggest Loser. Magazines such as Slimming and Health, Good Medicine, and Oxygen are all designed for the ‘health minded consumer’ (mostly women) wanting to lose weight. Whereas fatness was once a sign of leisure, beauty, and status, in Australia, obesity signifies laziness and poor health. Fatness is no longer just a weight problem; it’s like a full-body cancer.

Thinness is admired and important especially for women, defining what is ‘normal’. A toned and contained stomach is unequivocally positioned culturally as the only pathway to happiness. In a culture bursting with ‘skinny’ pregnant celebrities, it is no surprise that pregnant women are no longer immune to the battle of the bulge. In fact, medical concern over ‘fatness’ in pregnancy began in the 1930s in America and is arguably at its height today as ‘fat’ pregnant women like Lisa Graves are told that they will be unable to give birth in a hospital if their body size is outside of ‘normal’.

It’s no wonder that pregnant women are confused by the definition of ‘normal’. In one respect, pregnant women are encouraged to eat big in order to have a healthy baby. ‘Dieting’ during pregnancy is tantamount to child abuse in some cultures. How many times have you mentioned to a pregnant friend that she should have another piece of cake or an extra biscuit simply because she’s ‘eating for two’? After all, pregnancy is quite possibly the only time in a woman’s life when being ‘fat’ is acceptable.

However, doctors also encourage women to vigilantly survey their eating and not gain too much weight. Recent research has shown obesity to be a legitimate medical concern in pregnancy. Babies born to overweight women are more likely to be overweight by the age of three. Obese women have a greater risk of developing gestational diabetes and are more likely to have complicated births.

However, this 'anti-fat' mindset and the moral panic surrounding ‘fat’ pregnant women is ironic considering thin women requesting elective caesareans are heralded as 'smart' for avoiding the agony of childbirth but ‘fat’ women who want to give birth in a hospital are accused of failing to recognise the ‘risks’ associated with their body size. It has become painfully clear, especially if you are ‘fat’; birth is no longer seen as a ‘normal’ life process. Rather, it is an accident waiting to happen.
The arrogance that informs this contradiction is precisely why coming to the defense of 'fat' pregnant women is important and necessary. To turn pregnant women away from hospital and tell them to stop eating and lose weight or to just move on to another facility is as ridiculous as it is patronising. Reducing birth to a problem of body weight grossly oversimplifies a complicated physical process.

Now, it seems ‘fat’ women are worse than ‘teen mothers’ when it comes to winning the title for ‘most ill-equipped’ in managing their own pregnancies; it is these women who are seen as calculating, callous criminals who have little concern for the welfare of their unborn children simply by virtue of being ‘fat’. Lisa Graves should be applauded for being unashamed in her demand for the same compassionate treatment that thinner pregnant women are given. Is too much to ask that doctors stick to the Hippocratic Oath and accept that mothers in all shapes and sizes instead of continuing to demand perfection?

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